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Good local control, limited toxicity after stereotactic body reirradiation

Friday, March 4, 2011 (Last Updated: 03/07/2011)

FRIDAY, March 4 (HealthDay News) -- Stereotactic body radiotherapy results in good radiographic control and limited toxicity in progressive spinal metastases, according to a study published online Feb. 11 in Cancer.

Amit K. Garg, M.D., from the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues used stereotactic body radiotherapy to reirradiate 63 spinal tumors in 59 patients who had previously irradiated, progressive spinal metastasis. Stereotactic body radiotherapy was given at a peripheral dose of 30 grays in five fractions, or 27 grays in three fractions. Toxicity was evaluated using the National Cancer Institute Common Toxicity Criteria 2.0, and neurological status was evaluated using the McCormick neurological function system. Patients underwent spinal magnetic resonance imaging before treatment initiation and at regular intervals. Patients were followed up for an average of 17.6 months.

The investigators found that, at one year, the radiographic local control and overall survival were both 76 percent. Thirteen patients had tumors that progressed and were within 5 mm of the spinal cord, and six patients developed spinal cord compression. The most common toxicity was grade 1 or 2 fatigue. Two patients suffered from mild to moderate lumbar plexopathy radiation injury but remained ambulatory and free from pain. At one year, 92 percent of patients had no neurological deterioration from any cause.

"The current study supports the potential benefit of using stereotactic body radiotherapy technique for the reirradiation of progressive spinal metastases. Carefully selected patients may be expected to achieve good local tumor control with acceptable toxicity," the authors write.

Abstract
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Specialties Hematology & Oncology
Radiology
Orthopedics

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